. Minor and operative surgery, including bandaging . Racket-shaped incision for amputation of the finger at the metacarpo-phalangeal joint. (After Rotter.) and carrying the knife across this, dividing the tendonsand lateral ligament on the other side and cutting a flapfrom within outward. Removal of the head of the metacarpal bone if desiredmay be accomplished by the use of cutting pliers (); but, as a rule, this procedure is not to be recom-mended, for, although the deformity is lessened, thestrength of the hand is diminished. AMPUTATIONS OF THE METACARPAL BOXES. 497 In amputating the
. Minor and operative surgery, including bandaging . Racket-shaped incision for amputation of the finger at the metacarpo-phalangeal joint. (After Rotter.) and carrying the knife across this, dividing the tendonsand lateral ligament on the other side and cutting a flapfrom within outward. Removal of the head of the metacarpal bone if desiredmay be accomplished by the use of cutting pliers (); but, as a rule, this procedure is not to be recom-mended, for, although the deformity is lessened, thestrength of the hand is diminished. AMPUTATIONS OF THE METACARPAL BOXES. 497 In amputating the little and index fingers a full lateralflap may be cut on the free side, and an incision is nextcarried across the palmar surface to the angle of the web,and thence back to the joint, which is opened and the dis-articulation effected (Fig. 396, E). Fig. A. Disarticulation of distal phalanx: palmar flap. B. Amputation in con-tinuity by a circular flap. C. Metacarpophalangeal disarticulation. D. Ampu-tation of metacarpal bone in continuity. E. Disarticulation of little Disarticulation of fifth metacarpal bone. G. Amputation at the wrist,circular. H. Amputation at the wrist, lateral. (Stimson.) Amputations of the Metacarpal Bones.—In ampu-tating the metacarpal bones it is advisable to leave thecarpal ends of the bones to avoid opening the wrist-joint,except in the case of the first and fifth metacarpal bones,which do not communicate with the others and with thesynovial sacs. The incisions for the removal of the metacarpal bones 32 498 AMPUTATIONS. are the same as for the removal of a finger at the meta-carpophalangeal joint, the incision being prolonged back-ward as far as necessary over the dorsal surface of thebone (Fig. 396, _D.) After the metacarpal bone has beenbared for a sufficient distance, it is cut through with bon
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